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Bonomi F, Limido E, Weinzierl A, Harder Y, Menger MD, Laschke MW. Preconditioning strategies for improving the outcome of fat grafting. TISSUE ENGINEERING. PART B, REVIEWS 2024. [PMID: 38818802 DOI: 10.1089/ten.teb.2024.0090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2024]
Abstract
Autologous fat grafting is a common procedure in plastic, reconstructive and esthetic surgery. However, it is frequently associated with an unpredictable resorption rate of the graft depending on the engraftment kinetics. This, in turn, is determined by the interaction of the grafted adipose tissue with the tissue at the recipient site. Accordingly, preconditioning strategies have been developed following the principle of exposing these tissues in the pre-transplantation phase to stimuli inducing endogenous protective and regenerative cellular adaptations, such as the up-regulation of stress-response genes or the release of cytokines and growth factors. As summarized in the present review, these stimuli include hypoxia, dietary restriction, local mechanical stress, heat and exposure to fractional carbon dioxide laser. Preclinical studies show that they promote cell viability, adipogenesis and angiogenesis, while reducing inflammation, fibrosis and cyst formation, resulting in a higher survival rate and quality of fat grafts in different experimental settings. Hence, preconditioning represents a promising approach to improve the outcome of fat grafting in future clinical practice. For this purpose, it is necessary to establish standardized preconditioning protocols for specific clinical applications that are efficient, safe and easy to implement into routine procedures.
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Affiliation(s)
- Francesca Bonomi
- Saarland University, Institute for Clinical & Experimental Surgery, Homburg, Germany;
| | - Ettore Limido
- Saarland University, Institute for Clinical & Experimental Surgery, Homburg, Germany;
| | - Andrea Weinzierl
- Saarland University, Institute for Clinical & Experimental Surgery, Homburg, Germany
- University Hospital Zurich, Department of Plastic Surgery and Hand Surgery, Zurich, Switzerland;
| | - Yves Harder
- Ente Ospedaliero Cantonale (EOC), Department of Plastic, Reconstructive and Aesthetic Surgery, Ospedale Regionale di Lugano, Lugano, Switzerland
- Università della Svizzera italiana, Faculty of Biomedical Sciences, Lugano, Ticino, Switzerland;
| | - Michael D Menger
- Universitätsklinikum des Saarlandes, nstitut für Klinisch-Experimentelle Chirurgie, Geb. 65/66, Homburg, Germany, 66421;
| | - Matthias W Laschke
- Saarland University, Institute for Clinical & Experimental Surgery, Kirrbergerstrasse 100, Homburg, Germany, 66421;
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Cruciani M, Masiello F, Pati I, Pupella S, De Angelis V. Platelet rich plasma use for treatment of acne scars: an overview of systematic reviews. BLOOD TRANSFUSION = TRASFUSIONE DEL SANGUE 2024; 22:226-238. [PMID: 37677095 PMCID: PMC11073618 DOI: 10.2450/bloodtransfus.536] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 05/03/2023] [Accepted: 07/04/2023] [Indexed: 09/09/2023]
Abstract
BACKGROUND A reappraisal of the conclusions of systematic reviews (SRs) and meta-analyses validity related to Platelet-rich plasma (PRP), alone or in combination with other treatments, compared to regimens PRP-free for the treatment of acne scars. MATERIALS AND METHODS An overview of SRs. The methodological quality of the reviews was assessed using AMSTAR-2 checklist; quality of the evidence of primary studies was appraised following the GRADE approach. RESULTS Fifteen SRs were included in this overview. Data were from 124 overlapping reports, based on 34 individual primary studies (10 parallel arm randomized trials, 21 split-face studies, and 3 uncontrolled studies). Most of the studies evaluated combination of PRP with microneedling or with laser therapy compared to microneedling or laser therapy without PRP. Clinical improvement (reported as degree of improvement or improvement score) and patient's satisfaction rate were significantly higher in PRP recipients compared to controls. Crusting time and duration of erythema were significantly shorter in PRP recipients compared to controls. Most of the reviews considered in this overview can be considered of low methodological quality due to the fact that several critical methodological requirements of AMSTAR-2 checklist were unmet or partially met; only 6 of the 15 reviews incorporated study quality in their conclusions, and no GRADE assessment was performed for the reported outcomes in any of the SRs. With the GRADE approach, the quality of the evidence for the outcomes analysed ranged from very low to low due to risk of bias in the primary studies, inconsistency between the studies, and imprecision. DISCUSSION The low or very low certainty of evidence does not support clear clinical decision about the PRP use in combination with microneedling or laser therapy for the treatment of acne scars. Further well-designed studies are required to improve the evidence base for PRP combination therapy for acne scars.
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Affiliation(s)
- Mario Cruciani
- National Blood Centre, Italian National Institute of Health, Rome, Italy
| | - Francesca Masiello
- National Blood Centre, Italian National Institute of Health, Rome, Italy
| | - Ilaria Pati
- National Blood Centre, Italian National Institute of Health, Rome, Italy
| | - Simonetta Pupella
- National Blood Centre, Italian National Institute of Health, Rome, Italy
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Carver C, Rashid Z, Shuker S. Microneedling versus microcoring: A review of percutaneous collagen induction for the face and neck. J Cosmet Dermatol 2024; 23:1541-1550. [PMID: 38196306 DOI: 10.1111/jocd.16175] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2023] [Revised: 11/06/2023] [Accepted: 12/28/2023] [Indexed: 01/11/2024]
Abstract
BACKGROUND Microneedling (MN) and microcoring (MCT) are both methods used for percutaneous collagen induction. This minimally invasive technique involves creating controlled damage in cutaneous tissue to induce neocollagenesis and neoelastogenesis. MN utilizes solid microneedles and is commonly combined with radiofrequency (RF) to add thermal energy, while MCT involves hollow microneedles capable of removing excess tissue without inducing scar formation. AIMS The purpose of this review was to summarize recent literature for MN and MCT, with the goal of assisting clinical decision making regarding the use of these technologies. METHODS PubMed search was conducted for relevant articles published within the last 10 years. Scoping literature review was then performed with pertinent findings reported. RESULTS Existing literature investigating MCT is sparse. Limited data on in vivo, human effects of this technology exist. Two out of 14 studies in this review pertained to MCT. CONCLUSION Additional high-powered clinical studies are needed to guide future cosmetic treatments with MN and MCT.
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Affiliation(s)
- C Carver
- Midwestern University Arizona College of Osteopathic Medicine, Glendale, Arizona, USA
| | - Z Rashid
- La Peau Dermatology, Mesa, Arizona, USA
| | - S Shuker
- La Peau Dermatology, Mesa, Arizona, USA
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Liu B, Lin H, Zhang M. The clinical efficacy of single-hole punch excision combined with intralesional steroid injection for nodular keloid treatment: a self-controlled trial. Sci Rep 2024; 14:9793. [PMID: 38684804 PMCID: PMC11058828 DOI: 10.1038/s41598-024-60670-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2023] [Accepted: 04/25/2024] [Indexed: 05/02/2024] Open
Abstract
There are many methods to treat keloid, including various excision operations, laser, injection and radiotherapy. However, few studies have explored the effectiveness of single-hole punch excision in keloid treatment. This study aimed to investigate the efficacy and safety of lateral punch excision combined with intralesional steroid injection for keloid treatment through self-control trial. In this self-controlled trial, 50 patients meet the diagnosis of nodular keloid, and try to choose left-right symmetrical control, one skin lesion in the control group (50 skin lesionsin total) and the other in the observation group (50 skin lesions in total).The keloids in the treatment group were initially treated with punch excision combined with intralesional steroid injection, followed by injection treatment alone. Keloids in the control group received intralesional steroid injection alone. The Vancouver Scar Scale (VSS) of the keloid before and after the punch excision was evaluated; the keloid scores at different time points and the number of injection treatments required in both groups were compared, and adverse reactions were observed. The effective rate of the observation group was 86.0%, which was significantly higher than that of the control group (66.0%), and the recurrence rate of 22% was lower than that of the control group (χ2 = 4.141,63417), all of which were statistically significant (all P < 0.05). At the end of treatment, the VSS and total injection times in the observation group were significantly lower than those in the control group (t = 5.900,3.361), with statistical significance (P < 0.01). The combination of single-hole punch excision and intralesional steroid injection is an effective method to treat multiple nodular keloids, shortening the treatment course of tralesional steroid injection without obvious adverse reactions.
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Affiliation(s)
- Bingbing Liu
- Department of Dermatology, Chaohu Hospital Affiliated to Anhui Medical University, Chaohu, 238000, Anhui, China
| | - Haoying Lin
- Department of Dermatology, Chaohu Hospital Affiliated to Anhui Medical University, Chaohu, 238000, Anhui, China
| | - Minghai Zhang
- Department of Dermatology, Chaohu Hospital Affiliated to Anhui Medical University, Chaohu, 238000, Anhui, China.
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Hameedi SG, Saulsbery A, Olutoye OO. The Pathophysiology and Management of Pathologic Scarring-a Contemporary Review. Adv Wound Care (New Rochelle) 2024. [PMID: 38545753 DOI: 10.1089/wound.2023.0185] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/26/2024] Open
Abstract
Significance: Pathologic scarring occurs secondary to imbalances in the cellular mechanisms of wound healing and affects millions of people annually. This review article aims to provide a concise overview of the pathophysiology and management of pathologic scarring for clinicians and scientists alike. Recent Advances: Contemporary research in the field has identified aberrations in transforming growth factor-β/small mothers against decapentaplegic (TGF-β/SMAD) signaling pathways as key drivers of pathologic scar formation; indeed, this pathway is targeted by many treatment modalities and translational investigations currently underway. Although intralesional injection of corticosteroids has been the gold standard in the treatment of pathologic scarring, studies show greater treatment efficacy with the use of combination injections such as triamcinolone/5-fluorouracil and triamcinolone/botulinum toxin. Adjunctive therapies including ablative fractional carbon dioxide/erbium-doped yttrium aluminum garnet and non-ablative pulsed-dye lasers, microneedling, and carboxytherapy have shown encouraging results in small cohort studies. Translational investigations involving the use of nanogels, RNA interference, and small molecules targeting TGF-β/SMAD pathways are also currently underway and hold promise for the future. Critical Issues: The heterogeneous nature of hypertrophic scars and keloids poses significant challenges in formulating standardized treatment and assessment protocols, thereby limiting the conclusions that can be drawn. Future Directions: Rigorous clinical trials into the individual and synergistic effects of these therapies would be ideal before any definitive conclusions or evidence-based treatment recommendations can be made. Owing to the heterogeneity of the pathology and patient population, well-conducted cohort studies may be the next best option.
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Affiliation(s)
- Sophia G Hameedi
- Center for Regenerative Medicine, Nationwide Children's Hospital, Columbus, Ohio, USA
| | - Angela Saulsbery
- Center for Regenerative Medicine, Nationwide Children's Hospital, Columbus, Ohio, USA
| | - Oluyinka O Olutoye
- Center for Regenerative Medicine, Nationwide Children's Hospital, Columbus, Ohio, USA
- Department of Surgery, The Ohio State University, Columbus, Ohio, USA
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Qi C, Sun Q, Xiao D, Zhang M, Gao S, Guo B, Lin Y. Tetrahedral framework nucleic acids/hyaluronic acid-methacrylic anhydride hybrid hydrogel with antimicrobial and anti-inflammatory properties for infected wound healing. Int J Oral Sci 2024; 16:30. [PMID: 38622128 PMCID: PMC11018755 DOI: 10.1038/s41368-024-00290-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2023] [Revised: 02/23/2024] [Accepted: 02/25/2024] [Indexed: 04/17/2024] Open
Abstract
Bacterial resistance and excessive inflammation are common issues that hinder wound healing. Antimicrobial peptides (AMPs) offer a promising and versatile antibacterial option compared to traditional antibiotics, with additional anti-inflammatory properties. However, the applications of AMPs are limited by their antimicrobial effects and stability against bacterial degradation. TFNAs are regarded as a promising drug delivery platform that could enhance the antibacterial properties and stability of nanodrugs. Therefore, in this study, a composite hydrogel (HAMA/t-GL13K) was prepared via the photocross-linking method, in which tFNAs carry GL13K. The hydrogel was injectable, biocompatible, and could be instantly photocured. It exhibited broad-spectrum antibacterial and anti-inflammatory properties by inhibiting the expression of inflammatory factors and scavenging ROS. Thereby, the hydrogel inhibited bacterial infection, shortened the wound healing time of skin defects in infected skin full-thickness defect wound models and reduced scarring. The constructed HAMA/tFNA-AMPs hydrogels exhibit the potential for clinical use in treating microbial infections and promoting wound healing.
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Affiliation(s)
- Cai Qi
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases & West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Qiang Sun
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases & West China Hospital of Stomatology, Sichuan University, Chengdu, China
- Sichuan Provincial Engineering Research Center of Oral Biomaterials, Chengdu, China
| | - Dexuan Xiao
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases & West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Mei Zhang
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases & West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Shaojingya Gao
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases & West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Bin Guo
- Department of Stomatology, The First Medical Centre, Chinese PLA General Hospital, Beijing, China.
| | - Yunfeng Lin
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases & West China Hospital of Stomatology, Sichuan University, Chengdu, China.
- Sichuan Provincial Engineering Research Center of Oral Biomaterials, Chengdu, China.
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7
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Xia G, Dohi T, Abdelhakim M, Tosa M, Ogawa R. The effects of systemic diseases, genetic disorders and lifestyle on keloids. Int Wound J 2024; 21:e14865. [PMID: 38584345 PMCID: PMC10999570 DOI: 10.1111/iwj.14865] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2023] [Revised: 03/18/2024] [Accepted: 03/20/2024] [Indexed: 04/09/2024] Open
Abstract
Keloid are a fibroproliferative disorder caused by abnormal healing of skin, specifically reticular dermis, when subjected to pathological or inflammatory scars demonstrating redness, elevation above the skin surface, extension beyond the original wound margins and resulting in an unappealing cosmetic appearance. The severity of keloids and risk of developing keloids scars are subjected to elevation by other contributing factors such as systemic diseases, general health conditions, genetic disorders, lifestyle and natural environment. In particular, recently, daily physical work interpreted into mechanical force as well as the interplay between mechanical factors such as stress, strain and stiffness have been reported to strongly modulate the cellular behaviour of keloid formation, affect their location and shape in keloids. Herein, we review the extensive literature on the effects of these factors on keloids and the contributing predisposing mechanisms. Early understanding of these participating factors and their effects in developing keloids may raise the patient awareness in preventing keloids incidence and controlling its severity. Moreover, further studies into their association with keloids as well as considering strategies to control such factors may help clinicians to prevent keloids and widen the therapeutic options.
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Affiliation(s)
- Guangpeng Xia
- Department of Plastic, Reconstructive and Aesthetic SurgeryNippon Medical SchoolTokyoJapan
| | - Teruyuki Dohi
- Department of Plastic, Reconstructive and Aesthetic SurgeryNippon Medical SchoolTokyoJapan
| | - Mohamed Abdelhakim
- Department of Plastic, Reconstructive and Aesthetic SurgeryNippon Medical SchoolTokyoJapan
| | - Mamiko Tosa
- Department of Plastic, Reconstructive and Aesthetic SurgeryNippon Medical SchoolTokyoJapan
| | - Rei Ogawa
- Department of Plastic, Reconstructive and Aesthetic SurgeryNippon Medical SchoolTokyoJapan
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8
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Sun X, Jia X, Huang L. Microneedling Therapy for Striae Distensae: Systematic Review and Meta-Analysis. Aesthetic Plast Surg 2024:10.1007/s00266-024-03954-x. [PMID: 38509316 DOI: 10.1007/s00266-024-03954-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2023] [Accepted: 02/21/2024] [Indexed: 03/22/2024]
Abstract
INTRODUCTION Striae distensae (SD), linear scars of derma, caused by disproportionate skin stretching, which indicates a cosmetic problem and even endangers individuals' psychosocial health. Microneedling, representing a relatively new procedural therapy, has shown brightening but diverse results in the remedy of SD. Our study systematically investigates and further evaluates the efficacy of microneedling for SD. METHOD This study was conducted following the PRISMA guidelines. According to the preplanned search strategy, four electronic databases were comprehensively searched for eligible clinical controlled studies. Standardized mean difference (SMD) and odd ratio (OR) with 95% confidence intervals were calculated for continuous data and dichotomous data, respectively. RESULTS According to the predetermined criteria, eleven eligible articles of six RCTs and five non-RCTs were included. Concerning clinical improvement, a significant difference was observed in the microneedle radiofrequency treatment subgroup (SMD: 0.57, 95% CI 0.20-0.94, P = 0.003). The pooled result of the second subgroup revealed that microneedling and lasers producing almost comparable effectiveness for treating SD with no significant difference (P = 0.35). The analysis result of the third subgroup of microneedling versus non-laser therapy indicated significant difference at the 5% significance level (SMD:1.01, 95% CI 0.51-1.51, P < 0.0001). With regard to patient satisfaction, the pooled estimate concluded that participants' satisfaction with therapeutic effect between MRF and laser group was comparable (P = 0.26), whereas microneedling exhibited significant superiority than both laser (P = 0.04) and non-laser treatments (SMD: 0.95, 95% CI 0.52-1.38, P < 0.0001). Occurrence of post-inflammatory hyperpigmentation (PIH) was not obvious in microneedling therapy compared to other treatments, and a statistically difference was observed (P = 0.0003). Microneedling treatment caused significant pain compared with laser therapy (P < 0.00001). CONCLUSION This systematic review and meta-analysis has provided initial evidence of the efficacy and safety of microneedling technology for SD. LEVEL OF EVIDENCE II This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .
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Affiliation(s)
- Xiaochen Sun
- Laser Aesthetic Center, Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Ximeng Jia
- Laser Aesthetic Center, Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Lvping Huang
- Laser Aesthetic Center, Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
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Sethupathi SK, Poole M, Darji K, Fehlman J. Cosmetic Dermatology Concerns in Older Adults. Clin Geriatr Med 2024; 40:197-210. [PMID: 38000860 DOI: 10.1016/j.cger.2023.09.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2023]
Abstract
It is important to understand that each layer of facial tissue, from the underlying facial skeleton to the overlying skin, undergoes significant changes during the aging process. Bony support is lost along the mandible and maxilla and the orbital aperture widens. Superficial and deep fat pads undergo volume loss and migration and the overlying skin begins to reveal signs of both intrinsic aging with skin laxity and fine rhytids as well as extrinsic aging in the form of coarse, deeper rhytids and dyspigmentation.
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Affiliation(s)
- Sheetal K Sethupathi
- Department of Dermatology, Saint Louis University, 1008 S Spring Avenue, Saint Louis, MO 63110, USA
| | - Mackenzie Poole
- Saint Louis University School of Medicine, 1008 S Spring Avenue, Saint Louis, MO 63110, USA
| | - Kavita Darji
- Department of Dermatology, Saint Louis University, 1008 S Spring Avenue, Saint Louis, MO 63110, USA
| | - Jennifer Fehlman
- Saint Louis University SLU Care Physician Group -SSM Health, 2315 Dougherty Ferry Road, Suite 200C, Saint Louis, MO 63122, USA.
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10
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Miao L, Ma Y, Liu Z, Ruan H, Yuan B. Modern techniques in addressing facial acne scars: A thorough analysis. Skin Res Technol 2024; 30:e13573. [PMID: 38303407 PMCID: PMC10835023 DOI: 10.1111/srt.13573] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Accepted: 11/23/2023] [Indexed: 02/03/2024]
Abstract
BACKGROUND Facial acne scars are a prevalent concern, leading to the development of various treatment modalities. OBJECTIVES This review aims to explore the latest advancements in the treatment of facial acne scars, focusing on both surgical and non-surgical methods. METHODS The non-surgical treatments reviewed include topical medications (such as retinoids and alpha hydroxy acids) and non-invasive procedures (like microdermabrasion and chemical peels). Surgical options discussed are punch excision, subcision, and fractional laser treatments. RESULTS Combination therapy, integrating both surgical and non-surgical approaches, is frequently utilized to achieve optimal results in scar improvement. CONCLUSION Recent advancements in the treatment of facial acne scars provide promising options for individuals seeking improvement. However, these treatments have associated risks and potential adverse effects, highlighting the importance of consulting a dermatologist before beginning any treatment regimen.
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Affiliation(s)
- Linlin Miao
- Department of Dermatologythe First Affiliated Hospital of Ningbo UniversityNingboP. R. China
| | - Yizhao Ma
- Department of Dermatologythe First Affiliated Hospital of Ningbo UniversityNingboP. R. China
| | - Zhifang Liu
- Department of Dermatologythe First Affiliated Hospital of Ningbo UniversityNingboP. R. China
| | - Hongyu Ruan
- Department of Dermatologythe First Affiliated Hospital of Ningbo UniversityNingboP. R. China
| | - Bo Yuan
- Department of Dermatologythe First Affiliated Hospital of Ningbo UniversityNingboP. R. China
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Zawadzki T, Sitek A, Antoszewski B, Kasielska-Trojan A. Do Intraoperative Platelet-Rich Plasma Injections Influence the Final Appearance of Vertical Scars after Breast Reduction? Spectrophotometric Analysis. J Clin Med 2024; 13:691. [PMID: 38337385 PMCID: PMC10856486 DOI: 10.3390/jcm13030691] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2023] [Revised: 01/10/2024] [Accepted: 01/19/2024] [Indexed: 02/12/2024] Open
Abstract
Background: Platelet-rich plasma (PRP) has been shown to support wound healing and tissue regeneration due to its high concentration of growth factors and cytokines. This study aims to investigate the effect of intraoperative PRP injections on the final appearance of vertical scars after breast reduction, as well as to identify potential predictors of a scar's aesthetic assessment using spectrophotometric parameters. Methods: In this prospective, randomized trial, 82 scars from 41 women who underwent bilateral breast reduction with an inverted T pattern were analyzed. PRP or a placebo substance (0.9% sodium chloride solution) was injected intraoperatively into the edges of vertical wounds. Spectrophotometric measurements of scar pigmentation were performed 3 and 6 months after surgery; additionally, two independent observers evaluated the aesthetic appearance of scars based on photographs. Results: The results showed that the use of intraoperative PRP injections did not significantly influence the final appearance of vertical scars after breast reduction. Conclusions: We indicated spectrophotometric variables (b) in the early stages of wound healing (after 3 months) that can be predictors of the final scar's aesthetic outcome. This can be helpful in detecting scars that may need additional interventions to optimize the healing process.
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Affiliation(s)
- Tomasz Zawadzki
- Plastic, Reconstructive and Aesthetic Surgery Clinic, Institute of Surgery, Medical University of Lodz, 90-153 Lodz, Poland; (T.Z.); (B.A.)
| | - Aneta Sitek
- Department of Anthropology, University of Lodz, 90-237 Lodz, Poland;
| | - Bogusław Antoszewski
- Plastic, Reconstructive and Aesthetic Surgery Clinic, Institute of Surgery, Medical University of Lodz, 90-153 Lodz, Poland; (T.Z.); (B.A.)
| | - Anna Kasielska-Trojan
- Plastic, Reconstructive and Aesthetic Surgery Clinic, Institute of Surgery, Medical University of Lodz, 90-153 Lodz, Poland; (T.Z.); (B.A.)
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12
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Limido E, Weinzierl A, Harder Y, Menger MD, Laschke MW. Fatter Is Better: Boosting the Vascularization of Adipose Tissue Grafts. TISSUE ENGINEERING. PART B, REVIEWS 2023; 29:605-622. [PMID: 37166386 DOI: 10.1089/ten.teb.2023.0069] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/12/2023]
Abstract
Adipose tissue resorption after fat grafting is a major drawback in plastic and reconstructive surgery, which is primarily caused by the insufficient blood perfusion of the grafts in the initial phase after transplantation. To overcome this problem, several promising strategies to boost the vascularization and, thus, increase survival rates of fat grafts have been developed in preclinical studies in recent years. These include the angiogenic stimulation of the grafts by growth factors and botulinum neurotoxin A, biologically active gels, and cellular enrichment, as well as the physical and pharmacological stimulation of the transplantation site. To transfer these approaches into future clinical practice, it will be necessary to establish standardized procedures for their safe application in humans. If this succeeds, the surgical outcomes of fat grafting may be markedly improved, resulting in a significant reduction of the physical and psychological stress for the patients.
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Affiliation(s)
- Ettore Limido
- Institute for Clinical and Experimental Surgery, Saarland University, Homburg, Germany
| | - Andrea Weinzierl
- Institute for Clinical and Experimental Surgery, Saarland University, Homburg, Germany
- Department of Plastic Surgery and Hand Surgery, University Hospital Zurich, Zurich, Switzerland
| | - Yves Harder
- Department of Plastic, Reconstructive and Aesthetic Surgery, Ospedale Regionale di Lugano, Ente Ospedaliero Cantonale (EOC), Lugano, Switzerland
- Faculty of Biomedical Sciences, Università della Svizzera Italiana, Lugano, Switzerland
| | - Michael D Menger
- Institute for Clinical and Experimental Surgery, Saarland University, Homburg, Germany
| | - Matthias W Laschke
- Institute for Clinical and Experimental Surgery, Saarland University, Homburg, Germany
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13
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Kneiber D, Amin M, Nguyen TA, Gharavi NM. Review of radiofrequency microneedling: history, devices and uses. J COSMET LASER THER 2023; 25:59-64. [PMID: 37844087 DOI: 10.1080/14764172.2023.2268308] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2022] [Accepted: 10/04/2023] [Indexed: 10/18/2023]
Abstract
Radiofrequency microneedling (RFM) has recently become a popular choice for the treatment of various dermatologic conditions and rejuvenation. Many studies have sought to evaluate the efficacy of RFM. However, its role in the management of these conditions remains unclear. A comprehensive literature search including randomized controlled trials, cohort studies, and case series evaluating the efficacy of RFM in various skin conditions was performed. In this review, we discuss the history and mechanism of RFM, describe various device features, and discuss the use of RFM in various skin conditions and rejuvenation.
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Affiliation(s)
- Diana Kneiber
- Department of Dermatology, Kaiser Permanente Los Angeles Medical Center, Los Angeles, CA, USA
| | - Mina Amin
- Department of Dermatology, Kaiser Permanente Los Angeles Medical Center, Los Angeles, CA, USA
| | - Tuyet A Nguyen
- Department of Dermatology, Kaiser Permanente Los Angeles Medical Center, Los Angeles, CA, USA
| | - Nima M Gharavi
- Department of Dermatologic Surgery & Mohs Micrographic Surgery, Cedars-Sinai Medical Center, Beverly Hills, CA, USA
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14
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Hidajat D, Murlistyarini S. Successful treatment of rare adverse event after radiofrequency microneedle on Fitzpatrick skin type IV : a case report. J COSMET LASER THER 2023; 25:102-106. [PMID: 38245846 DOI: 10.1080/14764172.2024.2306982] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Accepted: 01/15/2024] [Indexed: 01/22/2024]
Abstract
Radiofrequency microneedle (RFM) is relatively safe to use for all skin types but there is still possibility of adverse events. Tram-track scarring or uniform papular eruptions is a rarely reported adverse event, but it is challenging to manage. We report a case of successful treatment of tram track scarring post RFM using a combination of light emitting diodes 640 nm and a salicylic acid peel and home treatment with a combination of azelaic acid and retinoic acid. There is still no standard therapy to treat this case. The results of clinical observations showed the lesions completely recovered in 6 months.
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Affiliation(s)
- Dedianto Hidajat
- Department of Dermatology and Venereology, University of Mataram, Mataram, Indonesia
| | - Sinta Murlistyarini
- Department of Dermatology and Venereology, Universitas Brawijaya, Malang, Indonesia
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15
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Abstract
Wound healing occurs as a response to disruption of the epidermis and dermis. It is an intricate and well-orchestrated response with the goal to restore skin integrity and function. However, in hundreds of millions of patients, skin wound healing results in abnormal scarring, including keloid lesions or hypertrophic scarring. Although the underlying mechanisms of hypertrophic scars and keloid lesions are not well defined, evidence suggests that the changes in the extracellular matrix are perpetuated by ongoing inflammation in susceptible individuals, resulting in a fibrotic phenotype. The lesions then become established, with ongoing deposition of excess disordered collagen. Not only can abnormal scarring be debilitating and painful, it can also cause functional impairment and profound changes in appearance, thereby substantially affecting patients' lives. Despite the vast demand on patient health and the medical society, very little progress has been made in the care of patients with abnormal scarring. To improve the outcome of pathological scarring, standardized and innovative approaches are required.
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Affiliation(s)
- Marc G Jeschke
- Hamilton Health Sciences, McMaster University, Hamilton, Ontario, Canada.
| | - Fiona M Wood
- Burns Service of Western Australia, Fiona Stanley Hospital, Perth Children's Hospital, Perth, Western Australia, Australia
- Burn Injury Research Unit, University of Western Australia, Perth, Western Australia, Australia
| | - Esther Middelkoop
- Burn Center, Red Cross Hospital, Beverwijk, Netherlands
- Association of Dutch Burn Centers (ADBC), Beverwijk, Netherlands
- Department of Plastic, Reconstructive and Hand Surgery, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
- Amsterdam Movement Sciences (AMS) Institute, Amsterdam UMC, Amsterdam, Netherlands
| | - Ardeshir Bayat
- Medical Research Council Wound Healing Unit, Hair and Skin Research Lab, Division of Dermatology, Department of Medicine, University of Cape Town & Groote Schuur Hospital, Cape Town, South Africa
| | - Luc Teot
- Department of Plastic Surgery, Burns, Wound Healing, Montpellier University Hospital, Montpellier, France
| | - Rei Ogawa
- Department of Plastic, Reconstructive and Aesthetic Surgery, Nippon Medical School, Tokyo, Japan
| | - Gerd G Gauglitz
- Department of Dermatology and Allergy, Ludwig-Maximilian University Munich, Munich, Germany
- Haut- und Laserzentrum Glockenbach, Munich, Germany
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16
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Kim Y, Yu H, An S, Ha D, Jung B. Handheld microfocused ultrasound device for facial lifting: A preliminary study of ULTIGHT. J Cosmet Dermatol 2023; 22:2982-2988. [PMID: 37183576 DOI: 10.1111/jocd.15813] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2023] [Revised: 04/11/2023] [Accepted: 05/02/2023] [Indexed: 05/16/2023]
Abstract
OBJECTIVE Although focused ultrasound modalities have achieved positive clinical results in noninvasive skin rejuvenation, they presented various side effects and particularly severe pain during treatment. This study introduces a microfocused ultrasound (MFU) device, ULTIGHT, to overcome the severe pain issue, providing quasi-facial lifting. MATERIALS AND METHODS Transducer surface was imaged with a scanning electron microscope. The energies of four treatment cartridges were measured using an ultrasound power meter. In vitro experiments were performed to quantitatively evaluate the MFU thermal zones (MFUTZs) and treatment line (TL) of 10 MFUTZs. Ex vivo experiments were performed to evaluate the MFUTZs and temperature rise in tissue. Clinical trials using eight volunteers were performed to qualitatively evaluate facial lifting. RESULTS The MFU transducer clearly showed a smooth and no air gap surface. ULTIGHT produced 10 discrete MFUTZs in a TL of length 10 mm. In ex vivo tissue, discrete linear MFUTZs were clearly observed at lower number of TLs; however, they started to aggregate at higher number of TLs. The temperature rise was linearly increased as a function of the number of treatments. A single MFUTZ resulted in a temperature rise of 3°C-10°C that could cause hyperthermia for body temperature. In the clinical trials, the volunteers showed quasi-facial lifting right after treatment on the lower facial region. CONCLUSIONS ULTIGHT provides relatively low energy, which may be advantageous or disadvantageous depending on clinical applications. Additionally, it has the advantage of being pain-free even without anesthetic during treatment, providing quasi-facial lifting right after treatment.
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Affiliation(s)
- Yongheon Kim
- Department of Biomedical Engineering, Yonsei University, Wonju-si, Korea
| | - Hyunseon Yu
- Department of Biomedical Engineering, Yonsei University, Wonju-si, Korea
| | | | | | - Byungjo Jung
- Department of Biomedical Engineering, Yonsei University, Wonju-si, Korea
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17
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Xiang J, Zhu Y, Xie Y, Chen H, Zhou L, Chen D, Guo J, Wang M, Cai L, Guo L. A Cu@ZIF-8 encapsulated antibacterial and angiogenic microneedle array for promoting wound healing. NANOSCALE ADVANCES 2023; 5:5102-5114. [PMID: 37705764 PMCID: PMC10496905 DOI: 10.1039/d3na00291h] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Accepted: 08/12/2023] [Indexed: 09/15/2023]
Abstract
Skin wounds caused by external injuries remain a serious challenge in clinical practice. Wound dressings that are antibacterial, pro-angiogenic, and have potent regeneration capacities are highly desirable for wound healing. In this study, a minimally invasive and wound-friendly Cu@ZIF-8 encapsulated PEGDA/CMCS microneedle (MN) array was fabricated using the molding method to promote wound healing. The MNs had good biocompatibility, excellent mechanical strength, as well as strong antibacterial properties and pro-angiogenic effects. When incubated with H2O2, Cu@ZIF-8 nanoparticles generated reactive oxygen species, which contributed to their antibacterial properties. Due to the oxidative stress of the cupric ions released from Cu@ZIF-8 and the anti-bacterial capability of the PEGDA/CMCS hydrogel scaffold, such an MN array presents excellent antibacterial activity. Moreover, with the continuous release of Cu ions from the scaffold, such MNs are effective in terms of promoting angiogenesis. With considerable biocompatibility and a minimally invasive approach, the degradable MN array composed of PEGDA/CMCS possessed superior capabilities to continuously and steadily release the loaded ingredients and avoid secondary damage to the wound. Benefiting from these features, the Cu@ZIF-8 encapsulated degradable MN array can dramatically accelerate epithelial regeneration and neovascularization. These results indicated that the combination of Cu@ZIF-8 and degradable MN arrays is valuable in promoting wound healing, which opened a new window for treatment of skin defection.
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Affiliation(s)
- Jieyu Xiang
- Department of Plastic Surgery, Zhongnan Hospital of Wuhan University Wuhan 430071 China
| | - Yufan Zhu
- Department of Spine Surgery and Musculoskeletal Tumor, Zhongnan Hospital of Wuhan University Wuhan 430071 China
| | - Yuanlong Xie
- Department of Spine Surgery and Musculoskeletal Tumor, Zhongnan Hospital of Wuhan University Wuhan 430071 China
| | - Hang Chen
- Department of Plastic Surgery, Zhongnan Hospital of Wuhan University Wuhan 430071 China
| | - Ling Zhou
- Department of Plastic Surgery, Zhongnan Hospital of Wuhan University Wuhan 430071 China
| | - Danyang Chen
- Department of Plastic Surgery, Zhongnan Hospital of Wuhan University Wuhan 430071 China
| | - Jia Guo
- Department of Plastic Surgery, Zhongnan Hospital of Wuhan University Wuhan 430071 China
| | - Min Wang
- Department of Plastic Surgery, Zhongnan Hospital of Wuhan University Wuhan 430071 China
| | - Lin Cai
- Department of Spine Surgery and Musculoskeletal Tumor, Zhongnan Hospital of Wuhan University Wuhan 430071 China
| | - Liang Guo
- Department of Plastic Surgery, Zhongnan Hospital of Wuhan University Wuhan 430071 China
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18
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Goslawski A, Tranchito E, Rabbani CC. Insights on in-office scar revision and resurfacing procedures. World J Otorhinolaryngol Head Neck Surg 2023; 9:249-256. [PMID: 37780675 PMCID: PMC10541167 DOI: 10.1002/wjo2.122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2023] [Revised: 06/08/2023] [Accepted: 06/28/2023] [Indexed: 10/03/2023] Open
Abstract
Objective Many facial plastic surgery procedures can be performed in an office-based setting, ranging from simple chemical peels to reconstructive surgeries to assist with scar revision. The aim of this review is to summarize the current state of facial plastics in-office surgical procedures, including scar revision, dermabrasion, lasers, and chemical peels. Methods A literature review was conducted with the PubMed search engine with the following keywords: facial plastics, scar revision, dermabrasion, lasers, chemical peels, face, office, and outpatient. The literature was surveyed for relevance, with a focus on realistically which procedures were performed in a facial plastics surgery outpatient clinic. These were then used to compile a review of the current state of this field. Results and Conclusions There are various scar revision procedures that can be performed in the office setting, including z-plasty, w-plasty, and geometric broken line closure techniques, as well as various nonmedical treatment options to improve the appearance of a scar. Dermabrasion can also be performed to assist with elevated scars. Various lasers are available to enhance cell turnover in the field of facial rejuvenation, scarring, and sun damage. Chemical peels are also available to assist with facial rejuvenation. With the appropriate counseling of the patient and medical staff, these can be safely performed in the office.
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Affiliation(s)
- Amanda Goslawski
- Department of Otolaryngology—Head & Neck SurgeryUniversity Hospitals Cleveland Medical CenterClevelandOhioUSA
- Case Western Reserve University School of MedicineClevelandOhioUSA
| | - Eve Tranchito
- Department of Otolaryngology—Head & Neck SurgeryUniversity Hospitals Cleveland Medical CenterClevelandOhioUSA
- Case Western Reserve University School of MedicineClevelandOhioUSA
| | - Cyrus C. Rabbani
- Department of Otolaryngology—Head & Neck SurgeryUniversity Hospitals Cleveland Medical CenterClevelandOhioUSA
- Case Western Reserve University School of MedicineClevelandOhioUSA
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19
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Qari S, Bader M, Farran E, Borrah R, Khamis S, Alharbi Z. Combined Synergetic Effect of Lipoconcentrate Fat Grafting, Nanofat Transfer, Platelet-Rich Plasma, Microneedling, and CO2 Fractional Laser for Plastic Regenerative and Esthetic Surgery and Cosmetic Care. Cureus 2023; 15:e44035. [PMID: 37746505 PMCID: PMC10517633 DOI: 10.7759/cureus.44035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/24/2023] [Indexed: 09/26/2023] Open
Abstract
The advancements in skin care methods and products show the rising interest in cosmetics. Recent studies emphasize the regenerative potential of fat grafting, platelet-rich plasma (PRP), microneedling, and carbon dioxide (CO2) fractional laser techniques. Combining these strategies into a protocol is yet to be explored. In this article, we demonstrate different types of fat grafts and their versatility in treating different facial problems found in our patient. This study evaluated the synergistic effect of lipoconcentrate and nanofat grafting, PRP, microneedling, and CO2 fractional laser to provide esthetic and regenerative facial skin care. This case report was conducted in Dr. Soliman Fakeeh Hospital, Saudi Arabia. Our case involved a 53-year-old woman who had traumatic facial injuries due to a car accident years ago that buried asphalt particles in her facial scars, causing bluish skin discoloration. She suffered from multiple deep atrophic scars in several areas on the left side of her face, causing asymmetry. She was treated using lipoconcentrate and nanofat grafting, followed by three PRP with microneedling sessions and then a final CO2 fractional laser session. The evaluation was based on the physician's clinical assessment, image documentation, and patient satisfaction, which revealed significant improvement in skin appearance with respect to texture, color, symmetry, and overall health of the skin over a period of four months. The potentiality and efficacy of the combination therapy of lipoconcentrate, nanofat, PRP, microneedling, and CO2 fractional laser for skin rejuvenation and scar treatment showed promising results in this case report.
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Affiliation(s)
- Sarah Qari
- Plastic Surgery and Burn Unit, Dr. Soliman Fakeeh Hospital, Jeddah, SAU
| | - Maryam Bader
- Plastic Surgery and Burn Unit, King Fahad General Hospital, Jeddah, SAU
| | - Eyas Farran
- College of Medicine, Fakeeh College for Medical Sciences, Jeddah, SAU
| | - Renad Borrah
- Plastic Surgery and Burn Unit, Dr. Soliman Fakeeh Hospital, Jeddah, SAU
| | - Sherif Khamis
- Plastic Surgery and Burn Unit, Dr. Soliman Fakeeh Hospital, Jeddah, SAU
- Clinical Sciences Department, Fakeeh College for Medical Sciences, Jeddah, SAU
| | - Ziyad Alharbi
- Plastic Surgery and Burn Unit, Dr. Soliman Fakeeh Hospital, Jeddah, SAU
- Clinical Sciences Department, Fakeeh College for Medical Sciences, Jeddah, SAU
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20
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Weßollek K, Marquardt Y, Wagner-Schiffler S, Baron JM, Huth S. Post-Treatment of Micro-Needling with a Dexpanthenol-Containing Ointment Accelerates Epidermal Wound Healing in Human 3D Skin Models. Clin Cosmet Investig Dermatol 2023; 16:1533-1538. [PMID: 37337567 PMCID: PMC10276988 DOI: 10.2147/ccid.s409310] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Accepted: 05/22/2023] [Indexed: 06/21/2023]
Abstract
Purpose In vitro study on the molecular effects of post-treatment after micro-needling applications with a dexpanthenol-containing ointment (DCO) using 3D skin models. Patients and Methods In this in vitro study, full-thickness human 3D skin models were treated with a micro-needling device according to its clinical application. For post-treatment, some of the models were additionally treated with a dexpanthenol-containing ointment (DCO). Histological samples were taken at 0, 24 and 48 hours. Gene expression analysis was performed after 24 hours. Results Histological examination showed that DCO post-treated 3D skin models revealed a completed wound closure 24 hours after the micro-needling procedure. In contrast, DCO-untreated models still clearly exhibited the micro-needling lesions after the same period of time. After 48 hours, all models revealed a completed wound healing. In skin models that received micro-needling but no post-treatment with DCO, microarray analysis identified an upregulation of proinflammatory cytokines and chemokines and a downregulation of skin barrier and differentiation markers. In contrast, post-treatment with DCO leads to accelerated wound healing without affecting the initial inflammatory response caused by micro-needling, which leads to the subsequent collagen expression. This data was supported by qRT-PCR analyses. Conclusion Post-treatment with DCO accelerates epidermal wound healing after micro-needling of 3D skin models without impairing the immunostimulatory properties of micro-needling. These findings can help to optimise the aftercare routine after micro-needling procedures and to shorten the downtime for the patient after treatment.
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Affiliation(s)
- Katharina Weßollek
- Department of Dermatology and Allergology, University Hospital RWTH Aachen, Aachen, Germany
| | - Yvonne Marquardt
- Department of Dermatology and Allergology, University Hospital RWTH Aachen, Aachen, Germany
| | | | - Jens Malte Baron
- Department of Dermatology and Allergology, University Hospital RWTH Aachen, Aachen, Germany
| | - Sebastian Huth
- Department of Dermatology and Allergology, University Hospital RWTH Aachen, Aachen, Germany
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21
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Wang M, Li X, Du W, Sun M, Ling G, Zhang P. Microneedle-mediated treatment for superficial tumors by combining multiple strategies. Drug Deliv Transl Res 2023; 13:1600-1620. [PMID: 36735217 PMCID: PMC9897165 DOI: 10.1007/s13346-023-01297-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/04/2023] [Indexed: 02/04/2023]
Abstract
Superficial tumors are still challenging to overcome due to the high risk and toxicity of surgery and conventional chemotherapy. Microneedles (MNs) are widely used in the treatment of superficial skin tumors (SST) due to the high penetration rate of the stratum corneum (SC), excellent biocompatibility, simple preparation process, high patient compliance, and minimal invasion. Most importantly, MNs can provide not only efficient and rarely painful delivery carriers, but also combine multi-model strategies with photothermal therapy (PTT), immunotherapy, and gene therapy for synergistic efficacy. To promote an in-depth understanding of their superiorities, this paper systematically summarized the latest application progress of MNs in the treatment of SST by delivering various types of photosensitizers, immune signal molecules, genes, and chemotherapy drugs. Just as important, the advantages, limitations, and drug release mechanisms of MNs based on different materials are introduced in the paper. In addition, the application of MN technology to clinical practice is the ultimate goal of all the work. The obstacles and possible difficulties in expanding the production of MNs and achieving clinical transformation are briefly discussed in this paper. To be anticipated, our work will provide new insights into the precise and rarely painful treatment of SST in the future.
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Affiliation(s)
- Meng Wang
- Shenyang Pharmaceutical University, No. 103, Wenhua Road, Shenyang, 110016, China
| | - Xiaodan Li
- Shenyang Pharmaceutical University, No. 103, Wenhua Road, Shenyang, 110016, China
| | - Wenzhen Du
- Shenyang Pharmaceutical University, No. 103, Wenhua Road, Shenyang, 110016, China
| | - Minge Sun
- Shenyang Narnia Biomedical Technology Company, Ltd, Shenyang, 110167, China
| | - Guixia Ling
- Shenyang Pharmaceutical University, No. 103, Wenhua Road, Shenyang, 110016, China
| | - Peng Zhang
- Shenyang Pharmaceutical University, No. 103, Wenhua Road, Shenyang, 110016, China.
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22
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Oranges CM, Viscardi JA, Eseme EA, Kalbermatten DF. Discussion: Comparison of the Effects of Skin Microneedling with Cupping Therapy and Microneedling Alone: An Experimental Study. Plast Reconstr Surg 2023; 151:1242-1243. [PMID: 37224342 DOI: 10.1097/prs.0000000000010135] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Affiliation(s)
- Carlo M Oranges
- From the Department of Plastic, Reconstructive, and Aesthetic Surgery, Geneva University Hospitals and University of Geneva
| | - Juan A Viscardi
- From the Department of Plastic, Reconstructive, and Aesthetic Surgery, Geneva University Hospitals and University of Geneva
| | - Ebai A Eseme
- From the Department of Plastic, Reconstructive, and Aesthetic Surgery, Geneva University Hospitals and University of Geneva
| | - Daniel F Kalbermatten
- From the Department of Plastic, Reconstructive, and Aesthetic Surgery, Geneva University Hospitals and University of Geneva
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23
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Salem RM, Salah SAE, Ibrahim SE. Microbotox injection versus its topical application following microneedling in the treatment of wide facial pores: A split face comparative study. J Cosmet Dermatol 2023; 22:1249-1255. [PMID: 36606384 DOI: 10.1111/jocd.15590] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2022] [Revised: 12/01/2022] [Accepted: 12/11/2022] [Indexed: 01/07/2023]
Abstract
BACKGROUND Enlarged facial pores and seborrhea are common cosmetic problems. Mesobotox has been proved to be effective safe therapeutic option. OBJECTIVE To compare the efficacy and longevity of intradermal mesobotox injection versus its topical application with microneedling for treatment of wide facial pores and seborrhea. MATERIALS AND METHODS This split face study was conducted on 20 patients with enlarged facial pores and seborrhea. One side of the face was treated with intradermal injection of botulinum toxin, the other was treated with its topical application following microneedling. Patient evaluation was performed after 1 month then after 4 months. CONCLUSION Microbotox can effectively and safely minimize enlarged facial pores with no downtime. Intradermal injection showed more patient satisfaction on the basis of greater efficacy, longevity of treatment than its topical application following microneedling.
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Affiliation(s)
| | | | - Samah Ezzat Ibrahim
- Dermatology and Andrology, Faculty of Medicine-Benha University, Benha, Egypt
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24
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Vacuum and Electromagnetic Fields Treatment to Regenerate a Diffuse Mature Facial Scar Caused by Sulfuric Acid Assault. BIOENGINEERING (BASEL, SWITZERLAND) 2022; 9:bioengineering9120799. [PMID: 36551005 PMCID: PMC9774184 DOI: 10.3390/bioengineering9120799] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/03/2022] [Revised: 12/05/2022] [Accepted: 12/12/2022] [Indexed: 12/15/2022]
Abstract
Acid attacks are on the rise, and they cause extensive and deep burns, especially on the face. The treatments used to improve the aesthetic, functional and social impact of non-acid scars do not always prove useful for acid scars. This article reports the case of a woman with an extended, mature, acid facial scar, caused by sulfuric acid assault, treated with a recent new procedure that combines the application of vacuum and electromagnetic fields. Before and after the treatment, the aesthetic appearance, and motor function of the face and neck were evaluated, as well as the level of hydration, the amount of sebum, the elasticity, and the pH of the skin. The improvements highlighted after the treatment of the aesthetic and functional characteristics of the face and neck, and of the physical parameters of the skin seemed to indicate that this particular treatment induces tissue regeneration, even in the nerve component. However, it is evident that the rehabilitation pathways of facial wounds and scars must be personalized, and must include continuous psychological support for the patient.
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25
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Disphanurat W, Sivapornpan N, Srisantithum B, Leelawattanachai J. Efficacy of a triamcinolone acetonide-loaded dissolving microneedle patch for the treatment of hypertrophic scars and keloids: a randomized, double-blinded, placebo-controlled split-scar study. Arch Dermatol Res 2022; 315:989-997. [PMID: 36383222 DOI: 10.1007/s00403-022-02473-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2022] [Revised: 11/09/2022] [Accepted: 11/10/2022] [Indexed: 11/17/2022]
Abstract
The treatment of hypertrophic scars (HTSs) and keloids remains a challenge. Intralesional triamcinolone acetonide (TAC) is the mainstay treatment for these conditions. Despite its efficacy, TAC has several adverse side effects, including telangiectasias, skin atrophy, pigmentary changes, and skin necrosis. Dissolving microneedles (DMN) use the poke-and-release method to create microchannels that enhance drug delivery to the target tissue in the dermis, without causing pain and with a decreased risk of transmission of blood-borne diseases. To evaluate and compare the efficacy of a TAC-DMN versus a drug-free DMN patch for the treatment of HTSs and keloids, 20 patients (10 with HTSs and 10 with keloids) received a split-scar treatment: one half of the scar length was treated with TAC-DMNs and the other half was treated with drug-free DMN for three sessions at 14-day intervals. Efficacy was assessed by measuring the scar volume through a multispectral imaging system and using the Patient and Observer Scar Assessment Scale (POSAS). The HTSs treated with TAC-DMNs showed a significant reduction in the mean scar volume 2 weeks after the second treatment and 1 month after the third treatment (p = 0.028 and 0.020, respectively), while the HTSs treated with drug-free DMNs showed no significant reduction in the scar volume. Both sides of the keloids showed no significant reduction in mean scar volume. Using the POSAS, significant improvement in the appearance of both halves of the HTSs was observed 1 month after the treatments. A significant improvement (evaluated by POSAS) was also observed in the keloids treated with TAC-DMNs 2 weeks after the second treatment and 1 month after the third treatment. No significant improvement was observed from the patients' perspective as evaluated by POSAS in the keloids treated with drug-free DMNs. However, no significant difference was observed between the treatment and control halves. TAC-DMN is an effective treatment for HTSs. Increasing the dosage and duration of keloid scar treatment is required in future studies to determine whether it would result in a significant therapeutic outcome. This trial is registered in the Thai Clinical Trials Registry (TCTR20220318004; date of registration, March 17, 2022).
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26
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Hendricks AJ, Farhang SZ. Dermatologic facial applications of Morpheus8 fractional radiofrequency microneedling. J Cosmet Dermatol 2022; 21 Suppl 1:S11-S19. [PMID: 35916259 DOI: 10.1111/jocd.15231] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2022] [Revised: 06/29/2022] [Accepted: 07/06/2022] [Indexed: 11/29/2022]
Abstract
Dermatologic patients are expressing increasing interest in minimally invasive procedures to address a wide range of common concerns from skin laxity to acne and scarring. Fractional radiofrequency (RF) microneedling offers an effective method for addressing a variety of dermatologic conditions with reduced downtime compared with historically more invasive procedural approaches. This article aims to describe the technology utilized in fractional RF microneedling (Morpheus8, InMode Aesthetics) and its studied applications in dermatology for treatment of the face.
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Affiliation(s)
- Aleksi J Hendricks
- Division of Dermatology, Department of Medicine, University of Arizona, Tucson, Arizona, USA
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27
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Legrand JMD, Martino MM. Growth Factor and Cytokine Delivery Systems for Wound Healing. Cold Spring Harb Perspect Biol 2022; 14:cshperspect.a041234. [PMID: 35667794 DOI: 10.1101/cshperspect.a041234] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Skin wound healing is a highly coordinated process involving multiple tissue-resident and recruited cell types. Cells within the wound microenvironment respond to key secreted factors such as pro-proliferative growth factors and immunomodulatory cytokines to repair the skin and promptly restore its essential barrier role. Therefore, recombinant growth factors and cytokines are promising therapeutics for skin wounds, in particular for large acute wounds such as burns, or wounds associated with underlying pathologies such as nonhealing chronic and diabetic wounds. However, translation of growth factors and cytokines into clinically effective treatments has been limited. Short half-life, poor stability, rapid diffusion, uncontrolled signaling, and systemic side effects are currently the key challenges to developing efficient growth factor- and cytokine-based therapies. To overcome these limitations, novel delivery systems have been developed to improve the regenerative potential of recombinant growth factors and cytokines. In this review, we discuss biomaterial and protein engineering strategies used to optimize the delivery of growth factor and cytokine therapeutics for skin wound treatment.
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Affiliation(s)
- Julien M D Legrand
- European Molecular Biology Laboratory Australia, Australian Regenerative Medicine Institute, Monash University, Clayton, Victoria 3800, Australia
| | - Mikaël M Martino
- European Molecular Biology Laboratory Australia, Australian Regenerative Medicine Institute, Monash University, Clayton, Victoria 3800, Australia
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Chilicka K, Rusztowicz M, Szyguła R, Nowicka D. Methods for the Improvement of Acne Scars Used in Dermatology and Cosmetology: A Review. J Clin Med 2022; 11:jcm11102744. [PMID: 35628870 PMCID: PMC9147527 DOI: 10.3390/jcm11102744] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2022] [Revised: 05/10/2022] [Accepted: 05/11/2022] [Indexed: 02/07/2023] Open
Abstract
Acne vulgaris is a chronic skin disease that, depending on its course, is characterized by the occurrence of various skin eruptions such as open and closed comedones, pustules, papules, and cysts. Incorrectly selected treatment or the presence of severe acne vulgaris can lead to the formation of atrophic scars. In this review, we summarize current knowledge on acne scars and methods for their improvement. There are three types of atrophic scars: icepick, rolling, and boxcar. They are of different depths and widths and have different cross-sections. Scars can combine to form clusters. If acne scars are located on the face, they can reduce the patient’s quality of life, leading to isolation and depression. There are multiple effective modalities to treat acne scars. Ablative lasers, radiofrequency, micro-needling, and pilings with trichloroacetic acid have very good treatment results. Contemporary dermatology and cosmetology use treatments that cause minimal side effects, so the patient can return to daily functioning shortly after treatment. Proper dermatological treatment and skincare, as well as the rapid implementation of cosmetological treatments, will certainly achieve satisfactory results in reducing atrophic scars.
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Affiliation(s)
- Karolina Chilicka
- Department of Health Sciences, Institute of Health Sciences, University of Opole, 45-040 Opole, Poland; (M.R.); (R.S.)
- Correspondence: ; Tel.: +48-665-43-94-43
| | - Monika Rusztowicz
- Department of Health Sciences, Institute of Health Sciences, University of Opole, 45-040 Opole, Poland; (M.R.); (R.S.)
| | - Renata Szyguła
- Department of Health Sciences, Institute of Health Sciences, University of Opole, 45-040 Opole, Poland; (M.R.); (R.S.)
| | - Danuta Nowicka
- Department of Dermatology, Venereology and Allergology, Wrocław Medical University, 50-368 Wrocław, Poland;
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Grieshaber E, Glorioso A. An Open-label Study Assessing the Efficacy and Tolerability of a Post-treatment Skincare Protocol Following Radiofrequency Microneedling for Facial Rejuvenation. THE JOURNAL OF CLINICAL AND AESTHETIC DERMATOLOGY 2022; 15:12-18. [PMID: 35642225 PMCID: PMC9122279] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
BACKGROUND A post-treatment skincare protocol (Finishing Touch™ Protocol; Colorescience®, Inc.) comprising several commercial products was developed for use after minimally invasive facial procedures. OBJECTIVE Our objective was to assess the effect of this post-treatment protocol on subject experiences following radiofrequency microneedling including confidence to resume normal activities, treatment satisfaction and likelihood for retreatment. METHODS Healthy female subjects, aged 21 to 65 years with Fitzpatrick Skin Types I to IV seeking facial rejuvenation with radiofrequency microneedling were enrolled (N=29). The microneedling procedure was performed during the baseline visit. Digital images were obtained before and immediately following microneedling, and after post-procedure application of the skincare protocol. A nonmedicated barrier ointment was also applied prior to the skincare protocol immediately following treatment in a third group of subjects. Subsequently, the skincare protocol was applied each morning after regular skincare routines. Subjects returned after four weeks for a final assessment, a self-assessment questionnaire, and treatment satisfaction ratings. RESULTS Following skincare protocol application, most subjects (97%) observed improvements in skin redness and/or treatment site marks, felt more confident (90%) and were very or extremely comfortable resuming normal activities (86%). Mild-to-moderate adverse events (n=4) resolved and were consistent with adverse events reported in the literature with no bleeding immediately following the microneedling with radiofrequency treatment. LIMITATIONS Primary limitations were the small number of subjects and self-reported outcomes. CONCLUSION Based on our results, the studied post-treatment skincare protocol appeared to improve subject confidence, comfort, satisfaction, and the likelihood of a repeat radiofrequency microneedling procedure among the included patients. No reported adverse events incremental to standard microneedling were observed.
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Affiliation(s)
- Elizabeth Grieshaber
- Both authors are with Terezakis and Grieshaber Dermatology in Metarie, Louisiana
| | - Alison Glorioso
- Both authors are with Terezakis and Grieshaber Dermatology in Metarie, Louisiana
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Shen YC, Chiu WK, Kang YN, Chen C. Microneedling Monotherapy for Acne Scar: Systematic Review and Meta-Analysis of Randomized Controlled Trials. Aesthetic Plast Surg 2022; 46:1913-1922. [PMID: 35426044 DOI: 10.1007/s00266-022-02845-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2021] [Accepted: 02/12/2022] [Indexed: 11/26/2022]
Abstract
INTRODUCTION Acne scarring, formed by the deposition of collagen following inflammatory acne, not only represents a cosmetic problem but also poses a psychological health risk to patients. As microneedling has become a common treatment for acne scarring, an increasing number of studies have compared the efficacy and safety of microneedling. In this study, we conducted a meta-analysis of randomized controlled trials (RCTs) comparing microneedling with other treatments. METHOD Three databases, namely Embase, PubMED, and Cochrane library, were searched until June 20, 2021, for RCTs only. Studies using microneedling in both treatments were excluded. RESULTS Twelve studies, totaling 414 participants, were included in our meta-analysis. For objective scar improvement, the pooled estimate analysis of the first group, treated with microneedling without radiofrequency, yielded a mean difference of 0.42 (95% CI-0.12-0.73%) with a significant difference at the 5% significance level. The second group, treated with fractional radiofrequency microneedling, exhibited no significance at the 5% significance level. Regarding subjective satisfaction, most results exhibited no significant difference between microneedling and other treatments. Although no case of secondary scarring or infection was reported in our study, the pooled result of postinflammatory hyperpigmentation was significant at the 5% significance level and preferred microneedling treatment. CONCLUSION Microneedling without radiofrequency achieved superior results in terms of scar improvement. No form of microneedling caused postinflammatory hyperpigmentation-an advantage in acne scar treatment. Thus, microneedling is a favorable choice for the treatment of acne scarring. LEVEL OF EVIDENCE III This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .
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Affiliation(s)
- Yu-Chun Shen
- School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Wen-Kuan Chiu
- Division of Plastic Surgery, Department of Surgery, Taipei Municipal Wanfang Hospital, Taipei Medical University, Taipei, Taiwan
- Department of Surgery, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Yi-No Kang
- Cochrane Taiwan, Taipei Medical University, Taipei, Taiwan
- Evidence-Based Medicine Center, Wan Fang Hospital, Medical University Hospital, Taipei, Taiwan
- Research Center of Big Data and Meta-analysis, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan
- Institute of Health Policy & Management, College of Public Health, National Taiwan University, Taipei, Taiwan
| | - Chiehfeng Chen
- Division of Plastic Surgery, Department of Surgery, Taipei Municipal Wanfang Hospital, Taipei Medical University, Taipei, Taiwan.
- Cochrane Taiwan, Taipei Medical University, Taipei, Taiwan.
- Evidence-Based Medicine Center, Wan Fang Hospital, Medical University Hospital, Taipei, Taiwan.
- Department of Public Health, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan.
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31
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Kang C, Lu D. Combined Effect of Microneedling and Platelet-Rich Plasma for the Treatment of Acne Scars: A Meta-Analysis. Front Med (Lausanne) 2022; 8:788754. [PMID: 35237616 PMCID: PMC8882957 DOI: 10.3389/fmed.2021.788754] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2021] [Accepted: 11/29/2021] [Indexed: 01/23/2023] Open
Abstract
Background Microneedling is a promising method for the treatment of acne scars, while the effect of microneedling combined with platelet-rich plasma (PRP) remains unknown. We performed a meta-analysis of controlled studies to compare the efficacy and safety of microneedling treatment with and without additional PRP in patients with acne scars. Methods Randomized and non-randomized controlled studies were identified by search of Medline, Embase, and Cochrane's Library databases. Results were pooled with a random-effects model, incorporating the possible heterogeneity. Results Four randomized and 10 split-face non-randomized controlled studies with 472 patients were included. Compared to microneedling therapy without PRP, combined treatment with microneedling and PRP was associated with increased odds of clinical improvement of >50% in Goodman's qualitative scale [GQS: odds ratio (OR): 2.97, 95% confidence interval (CI): 1.96–4.51, p < 0.001; I2 = 0%], and a significantly improved mean GQS score (mean difference: −0.32, 95% CI: −0.44 to −0.20, p < 0.001; I2 = 0%). Combined treatment was associated with a higher patient satisfying rate (OR: 4.15, 95% CI: 2.13 to 8.09, p < 0.001; I2 = 53%), while the incidence of severe adverse events such as severe erythema (OR: 1.59, 95% CI:.73 to 3.46, P = 0.24; I2 = 0%) and severe edema (OR: 1.14, 95% CI: 0.47 to 2.76, P = 0.77; I2 = 0%) were not significantly different. Conclusions Combined treatment with microneedling with PRP is more effective than microneedling without PRP for patients with acne scars.
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32
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Abbas MAM, Elgamal EEAE, Zaky MS, Elsaie ML. Microneedling with topical Vitamin C versus Microneedling with topical insulin in the treatment of atrophic post-acne scars: A Split-face study. Dermatol Ther 2022; 35:e15376. [PMID: 35150195 DOI: 10.1111/dth.15376] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2022] [Accepted: 02/09/2022] [Indexed: 11/27/2022]
Abstract
BACKGROUND Post acne scars following sebaceous injury and abnormal wound healing during the course of acne is a prevalent and challenging to treat condition. AIM OF THE WORK To evaluate microneedling by dermapen with topical vitamin C versus microneedling with topical insulin in treating atrophic post-acne scars. PATIENTS AND METHODS A split -face comparative study included 30 subjects with atrophic post-acne scars. Human insulin was topically applied to the left side of the face and on the right side, vitamin C serum was applied. Scars were assessed via the Acne Scar Assessment Scale (ASAS) and Scar quartile grading scale (SQGS). RESULTS After one month of 4 treatments, a statistically significant mean improvement in ASAS value was reported on both split sides of the face (2.13 and 1.83) compared to baseline (3.03 and 2.93) (p=0.005; p=0.001 respectively). When compared to baseline, the mean ASAS value improved significantly with a slight more improvement on the vitamin c treated side CONCLUSION: Topical insulin and vitamin c combined with microneedling, may both achieve comparable significant improvement for treating post acne scars. Insulin can be a promising novel anti-scarring therapy pending larger controlled studies to verify its efficacy. This article is protected by copyright. All rights reserved.
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Affiliation(s)
| | | | - Mohamed Shokry Zaky
- Department of Dermatology, Venereology and Andrology, Damietta Faculty of Medicine, Al-Azhar University, Egypt
| | - Mohamed L Elsaie
- Department of Dermatology, Medical Research and Clinical Research Institute, National Research Centre, Egypt
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33
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Salameh F, Shumaker PR, Goodman GJ, Spring LK, Seago M, Alam M, Al-Niaimi F, Cassuto D, Chan HH, Dierickx C, Donelan M, Gauglitz GG, Haedersdal M, Krakowski AC, Manuskiatti W, Norbury WB, Ogawa R, Ozog DM, Paasch U, Victor Ross E, Clementoni MT, Waibel J, Bayat A, Goo BL, Artzi O. Energy-based devices for the treatment of acne scars: 2021 international consensus recommendations. Lasers Surg Med 2021; 54:10-26. [PMID: 34719045 DOI: 10.1002/lsm.23484] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2021] [Accepted: 10/03/2021] [Indexed: 02/06/2023]
Abstract
BACKGROUND AND OBJECTIVES Acne scars are one of the most distressing and long-term consequences of acne vulgaris, with damaging effect on a person's physical, mental, and social well-being. Numerous treatment options are available including surgical and nonsurgical techniques, depending on the clinical presentation. Although considerable advances in the development of new treatment technologies and applications have been made in the last decade, international treatment guidelines and reimbursement schemes have not yet caught up with current knowledge and practice in many centers. The authors intend to highlight the potential utility of energy-based devices (EBDs) for acne scarring, offer recommendations for safe and efficacious treatment, and provide consensus-based EBD treatment options based on varying presentations demonstrated in a series of real-life clinical photographs. STUDY DESIGN/MATERIALS AND METHODS An international panel of 24 dermatologists and plastic surgeons from 12 different countries and a variety of practice backgrounds was self-assembled to develop updated consensus recommendations for the treatment of acne scars. A two-step modified Delphi method took place between March 2020 and February 2021 consisting of two rounds of emailed questionnaires. The panel members approved the final manuscript via email correspondence. RESULTS The manuscript includes a comprehensive discussion and panel recommendations regarding the following topics: 1. the role of EBD in mitigating and treating acne scars in a patient with active acne, 2. the use of various EBDs for the treatment of different acne scar types with special focus on commonly used laser platform such as vascular lasers, ablative fractional lasers (AFLs) and non-AFLs (NAFLs), 3. treatment combinations, and 4. acne scar treatments in skin of color. The last part comprised of 10 photos of real-life clinical cases with the panel recommendation treatment plan to achieve best aesthetic outcome. CONCLUSION Panel members were unanimous in their view that EBDs have a role in the management of acne scars, with AFLs, NAFLs, vascular lasers, and RF devices preferentially selected by most of the panel experts. EBDs are considered a first-line treatment for a variety of acne scar types and patients without access to these treatments may not be receiving the best available care for optimal cosmetic results. Future high-quality research and updated international treatment guidelines and reimbursement schemes should reflect this status.
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Affiliation(s)
- Fares Salameh
- Department of Dermatology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - Peter R Shumaker
- VA San Diego Healthcare System and University of California, San Diego, California, USA
| | - Greg J Goodman
- Department of General Practice, Monash University, Clayton, Victoria, Australia
| | - Leah K Spring
- Micrographic Surgery and Surgical Oncology, SkinCare Physicians, Chestnut Hill, Massachusetts, USA
| | - Meghan Seago
- VA San Diego Healthcare System and University of California, San Diego, California, USA.,Micrographic Surgery and Surgical Oncology, Scripps Clinic, La Jolla, California, USA
| | - Murad Alam
- Department of Dermatology, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | | | | | - Henry Hl Chan
- Private Practice and Department of Medicine (Dermatology), University of Hong Kong, People's Republic of China
| | | | - Matthias Donelan
- Department of Surgery, Massachusetts General Hospital, Shriners Hospitals for Children-Boston, Harvard Medical School, Boston, Massachusetts, USA
| | - Gerd G Gauglitz
- Department of Dermatology and Allergy, Ludwig Maximillian University, Munich, Germany
| | - Merete Haedersdal
- Department of Dermatology, Bispebjerg Hospital, University of Copenhagen, Copenhagen, Denmark
| | - Andrew C Krakowski
- Department of Dermatology, St. Luke's University Health Network, Easton, Pennsylvania, USA
| | | | - William B Norbury
- Department of Surgery, University of Texas Medical Branch, Shriners Hospital for Children-Galveston, Galveston, Texas, USA
| | - Rei Ogawa
- Department of Plastic, Reconstructive and Aesthetic Surgery, Nippon Medical School, Tokyo, Japan
| | - David M Ozog
- Department of Dermatology, Henry Ford Hospital, Detroit, Michigan, USA
| | - Uwe Paasch
- Department of Dermatology, Venereology, and Allergy, University of Leipzig, Leipzig, Germany
| | | | | | - Jill Waibel
- Miami Dermatology and Laser Institute, Miami, Florida, USA
| | - Ardeshir Bayat
- Plastic & Reconstructive Surgery Research, Centre for Dermatology Research, NIHR Manchester Biomedical Research Centre, University of Manchester, England, UK.,MRC-SA Wound Healing Unit, Hair & Skin Research Laboratory, Division of Dermatology, University of Cape Town, Cape Town, South Africa
| | - Boncheol Leo Goo
- Naeum Dermatology and Aesthetic Clinic/Skin Rehabilitation Center, Seoul, Korea
| | - Ofir Artzi
- Department of Dermatology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
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34
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Casabona G, Alfertshofer MG, Kaye KO, Frank K, Mercado-Perez A, Hargiss JB, Green JB, Cotofana S. Safety and efficacy of microneedling technology in the treatment of acne scars. J Cosmet Dermatol 2021; 20:3482-3491. [PMID: 34596936 DOI: 10.1111/jocd.14502] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2021] [Revised: 08/12/2021] [Accepted: 09/21/2021] [Indexed: 01/19/2023]
Abstract
BACKGROUND Current options for the reduction of acne scarring (eg, ablative laser resurfacing) are associated with considerable side effects and limitations in terms of patient population. Percutaneous collagen induction via microneedling poses an alternative treatment method due to its low rates of reported adverse events and side effects. OBJECTIVE To assess the safety and effectiveness of microneedling treatments in reducing acne scars. METHODS A total of 22 patients (18 females and 4 males) with a mean age of 38 ± 7.6 years were assessed regarding the appearance of facial acne scarring. Acne scars were assessed via the Acne Scar Assessment Scale (ASAS) and the Goodman and Baron acne scar grading scale before and after two/three treatments. Additionally, the post-interventional development of side reactions, adverse events, and patient-reported outcomes (eg, pain/discomfort, skin redness) was reported. RESULTS Compared to baseline, the mean ASAS value was improved statistically significantly on average by 1.41 and 1.46 after the second treatment as assessed by the independent raters and the patients, respectively. In patients who received a total of three treatments, a statistically significant mean improvement in ASAS value of 1.35 and 1.66 compared to baseline was assessed by the independent raters and patients, respectively. No unexpected adverse events were reported. The severity and rate of side reactions decreased over the course of this study. CONCLUSION Microneedling treatments can pose a safe and effective option in the reduction of acne scarring. In this study, microneedling helped achieving a significant reduction of acne scars while showing high patient safety.
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Affiliation(s)
| | - Michael G Alfertshofer
- Department of Hand, Plastic, and Aesthetic Surgery, Ludwig Maximilian University, Munich, Germany
| | | | - Konstantin Frank
- Department of Hand, Plastic, and Aesthetic Surgery, Ludwig Maximilian University, Munich, Germany
| | - Arnaldo Mercado-Perez
- Department of Clinical Anatomy, Mayo Clinic College of Medicine and Science, Rochester, Minnesota, USA
| | - John B Hargiss
- Department of Clinical Anatomy, Mayo Clinic College of Medicine and Science, Rochester, Minnesota, USA
| | - Jeremy B Green
- Skin Associates of South Florida and Skin Research Institute, Coral Gables, Florida, USA
| | - Sebastian Cotofana
- Department of Clinical Anatomy, Mayo Clinic College of Medicine and Science, Rochester, Minnesota, USA
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35
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Elsaie ML. Update on management of keloid and hypertrophic scars: A systemic review. J Cosmet Dermatol 2021; 20:2729-2738. [PMID: 34169622 DOI: 10.1111/jocd.14310] [Citation(s) in RCA: 41] [Impact Index Per Article: 13.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Accepted: 06/14/2021] [Indexed: 01/11/2023]
Abstract
Numerous therapeutic strategies have been described for prevention and reduction of hypertrophic scars and keloids, but none of the treatments is effective in all patients. No universal consensus in treatment regimen has been established, and there is limited evidence-based literature to guide the correct management. The process of scar development is complex and requires deeper understanding of the molecular mechanisms that cause their development and recurrences. Despite many available modes of targeting keloid and hypertrophic scars, yet they remain an ongoing challenge to patients and clinicians. To date, no one therapy has been universally accepted as the gold standard for the treatment of all excessive scars nor has the capability of complete scar resolution The search of literature included peer-reviewed articles including clinical trials and scientific reviews. Literature was identified from electronic databases (MEDLINE/PubMed) through May 2021 and references of respective articles and only the articles published in English language were included.
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Affiliation(s)
- Mohamed L Elsaie
- Department of Dermatology, National Research Centre, Cairo, Egypt
- University of Miami Miller School of Medicine, Miami, FL, USA
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36
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Yao S, Chi J, Wang Y, Zhao Y, Luo Y, Wang Y. Zn-MOF Encapsulated Antibacterial and Degradable Microneedles Array for Promoting Wound Healing. Adv Healthc Mater 2021; 10:e2100056. [PMID: 33938635 DOI: 10.1002/adhm.202100056] [Citation(s) in RCA: 76] [Impact Index Per Article: 25.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2021] [Revised: 04/22/2021] [Indexed: 12/19/2022]
Abstract
An infected skin wound caused by external injury remains a serious challenge in clinical practice. Wound dressings with the properties of antibacterial activity and potent regeneration capacity are highly desirable for wound healing. In this paper, a degradable, ductile, and wound-friendly Zn-MOF encapsulated methacrylated hyaluronic acid (MeHA) microneedles (MNs) array is fabricated through the molding method for promoting wound healing. Due to the damage capability against the bacteria capsule and oxidative stress of the zinc ion released from the Zn-MOF, such MNs array presents excellent antibacterial activity, as well as considerable biocompatibility. Besides, the degradable MNs array composed of photo-crosslinked MeHA possesses the superior capabilities to continuously and steadily release the loaded active ingredients and avoid secondary damage to the wound. Moreover, the low molecular weight hyaluronic acid (HA) generated by hydrolysis of MeHA is also conducive to tissue regeneration. Benefiting from these features, it has been demonstrated that the Zn-MOF encapsulated degradable MNs array can dramatically accelerate epithelial regeneration and neovascularization. These results indicate that the combination of MOFs and degradable MNs array is of great value for promoting wound healing.
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Affiliation(s)
- Shun Yao
- State Key Laboratory of Toxicology and Medical Countermeasures Institute of Pharmacology and Toxicology Academy of Military Medical Sciences Beijing 100850 China
| | - Junjie Chi
- Department of Rheumatology and Immunology Institute of Translational Medicine The Affiliated Drum Tower Hospital of Nanjing University Medical School Nanjing 210008 China
- State Key Laboratory of Bioelectronics School of Biological Science and Medical Engineering Southeast University Nanjing 210096 China
- Wenzhou Institute University of Chinese Academy of Sciences Wenzhou Zhejiang 325001 China
| | - Yuetong Wang
- Department of Rheumatology and Immunology Institute of Translational Medicine The Affiliated Drum Tower Hospital of Nanjing University Medical School Nanjing 210008 China
- State Key Laboratory of Bioelectronics School of Biological Science and Medical Engineering Southeast University Nanjing 210096 China
| | - Yuanjin Zhao
- Department of Rheumatology and Immunology Institute of Translational Medicine The Affiliated Drum Tower Hospital of Nanjing University Medical School Nanjing 210008 China
- State Key Laboratory of Bioelectronics School of Biological Science and Medical Engineering Southeast University Nanjing 210096 China
| | - Yuan Luo
- State Key Laboratory of Toxicology and Medical Countermeasures Institute of Pharmacology and Toxicology Academy of Military Medical Sciences Beijing 100850 China
| | - Yongan Wang
- State Key Laboratory of Toxicology and Medical Countermeasures Institute of Pharmacology and Toxicology Academy of Military Medical Sciences Beijing 100850 China
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